1. Field of the Invention
This invention relates to surgical equipment used in surgery and more particularly to surgical instrument positioning and holding means for aiding surgeons by acting as an extra hand.
2. Description of the Related Art
Prior instrument holders have been bulky and unwieldy, protruding across the operating area in order to provide great adjustability and access to the entire operating area for the instrument held. When put into use, the surgeon would sometimes have to work around the instrument holder when the instrument holder is actually there to accommodate the surgeon. While enabling some enhancements to surgical procedures, prior instrument holders did not perform as well as might be expected.
A variety of devices have been developed to assist at surgery for the purpose of three dimensionally positioning and then holding a surgical instrument. One variety of such devices utilizes a series of bars and clamps, with a terminal clamp positioned to assist in the instrument being held.
An improvement on such a device is a flexible arm device made up of a series of interlockable segments strung on a cable such that all of the segments have some freedom of movement along this cable, but when the cable is tightened the segments are pulled together and the individual segments become fixed. This is known as a gooseneck holder. While the ability to move one variable arm is an advantage over the need to simultaneously control multiple connections, as in the rod and clamp type devices, some significant problems still persist.
First, since it is necessary for the gooseneck holder arm to both reach the full extent of where it needs to go and yet be able to work close to its point of origin, it must be twice as long as the needed reach to be capable of being doubled back to return its point of origin. This is a problem because as the length of the arm and the number of segments is increased the device becomes less rigid, less stable and requires more and more cable excursion and force to gain any significant segment to segment interlock.
Secondly, while the flexible arm portion itself is stabilized by a fixed windlass mechanism at the base, this does not control the terminal instrument grasping clamp so that the surgeon must still contend with controlling several things at once.
Thirdly, while working with the holder in any position other than fully extended, the redundant portion is often a hindrance to the surgeon, compromising his visualization or access into the wound or obstructing the path of his hand as he works.
Fourthly, because of the relative long length of the flexible segments made necessary by its need to retain the capacity of being workable close to its origin, as well as at its furthest reach, the windlass mechanism needs to be of considerable length and have a relatively large handle to be able to tighten up sufficient cable slack and to have sufficient mechanical advantage so as to generate the force needed to actively pull the segments tight enough to effect a relative lock. The bulk of the positioning windlass and handle obstruct the surgeon's access and the movement of his hands about the wound, and compromises the passing of instruments into and out of the wound.
Fifthly, the long flexible arm and cable length have required multiple turns of the handle to tighten the segments of the gooseneck. Such turning is generally a problem because of the proximity of the base to the patient's body making such movements difficult.
Sixthly, the terminal instrument grasping clamp has generally been a grasp clamp bound centrally to the flexible arm and with a handle extending from one end and the grasping means or clamp portion from the other end. This is constantly in the surgeon's way, interfering with his line of sight and the free movement of his hand.
There is therefore a need for a clamp device embodying the advantages of a flexible gooseneck arm but improving it so that it is less intrusive, more efficient, and more adjustably deployable. There is also a need to eliminate the need for redundancy in the length of the flexible arm and a need for a simple means to lock the flexible segments, the terminal instrument grasping portions, and the support base in place.